Anal Sex Safety: Everything You Need to Know

Is it safe?

Anal sex is a bit of a taboo subject, despite the fact that it’s an increasingly popular sexual activity. As more couples explore this type of sex, understanding the risks, rewards, and proper strategy is important.

According to the Centers for Disease Control (CDC), anal sex is primarily growing in popularity with couples under age 45. In fact, in a national survey, 36 percent of women and 44 percent of men reported that they’ve had anal sex with an opposite-sex partner.

You might think of anal sex as anal penetration with a penis, but you have a few more options. Anal sex can also be performed with fingers or the tongue. Sex toys, like vibrators, dildos, and butt plugs, are used too.

Like any sexual activity, anal sex isn’t inherently unsafe. It just requires more planning, prep, and communication than some other forms of sexual activity. Safety during sex should be a top priority, but having fun is certainly important, too. Keep reading to learn more.

Things to consider

If you’re curious about anal sex, it’s important to be prepared before your next bedroom romp. Following proper precautions — which we’ll get to — is the only way to reduce your risk of injury or illness. And when you feel confident, you’re more likely to enjoy the experience.

Here’s what you need to know beforehand:

1. Unlike the vagina, the anus lacks lubrication

The vagina is a bit of a natural wonder. When a woman is aroused, the vagina provides its own lubricant for sex. The anus, however, does not. That means you have to provide it. Penetration without lubrication can tear the delicate tissue inside the anus, which can lead to pain and bleeding.

2. As with vaginal tissue, tissue inside the anus is more sensitive than tissue outside the anus

The tissue and skin around the anus acts as a protective barrier for the bottom half of your digestive tract. However, the tissue inside the anus is thinner, delicate, and more likely to tear and bleed as a result of penetration. This increases the likelihood of passing infections, viruses, or bacteria between partners. Even two partners who don’t have any sexually transmitted infections (STIs) can still pass bacteria between each other through these tears in the skin.

3. Like the vagina, the anus has a muscle that must relax to allow comfortable penetration

The anal sphincter acts as a bit of a gatekeeper for the rectum. For anal sex, however, it’s important that this muscle relaxes. Not only does it make the experience more pleasurable, it reduces the risk of tearing or discomfort. Relaxation involves patience, both at the time you’re attempting penetration, and as you become more accustomed to anal sex.

4. Like the vagina, the anus has bacteria

An STI isn’t the only thing you have to worry about sharing with anal sex. Bacteria living in or near the anus can be easily spread if you don’t take precautions to tidy up after anal penetration.

If you’re wearing a condom, be sure to remove it and roll on a new one before moving on to vaginal sex. If you’re not wearing a condom or if you’re using your hands or a toy, be sure to wash thoroughly after anal sex. Bacteria, such as hepatitis A and E. coli, can be spread from unclean anal sex practices.

Common concerns

For couples considering anal sex, answers to these common questions might help you decide if it’s right for you.

1. Will it hurt?

Yes and no. If done correctly, it can feel great. But that doesn’t mean you won’t experience some discomfort the first time — or even the first few times — you have anal penetration. Take your time, stop if it becomes uncomfortable, and try using fewer fingers or a smaller toy as you become accustomed to the sensation.

2. Is it normal to bleed?

Yes and no. It’s possible you will experience some bleeding your first time or two. However, the bleeding should stop in future sessions. If it doesn’t, or if bleeding grows worse with each round of intercourse, talk with your doctor. This may result from rough penetration or be a sign of an underlying concern.

3. Will it affect my ability to poop?

You might experience an urge to use the bathroom soon after your raunchy romp is over, but anal sex won’t prevent you from pooping. And, despite urban myths and one somewhat-flawed study that suggests otherwise, anal sex won’t stretch out your anus and prevent you from holding in bowel movements.

4. Other side effects and risks

A few other side effects are possible with anal sex. These include:

Spreading STIs.Infections and diseases that are shared during sexual intercourse — such as HIV, gonorrhea, chlamydia, and herpes — can be shared through anal sex. In fact, anal sex is the riskiest sexual behavior for transmitting and getting HIV for both men and women. People on the receiving end (or “the bottom”) of anal sex are 13 times more likely to become infected with HIV than the inserting partner (or “the top”).

Hemorrhoids. Stretching and pushing from anal sex can irritate existing hemorrhoids, but it’s unlikely to cause the dilated and stretched blood vessels inside the rectum and anus.

Colon perforation. This is very uncommon, but it’s possible that anal penetration can puncture a hole in your colon. Surgical repair is necessary, so if you experience heavy rectal bleeding and abdominal pain following anal sex, see your doctor.

How to practice safe anal sex

Anal sex can be a great way to have fun with your partner. You just need to give this new sexual adventure a bit of planning and preparation. As long as the two of you are on the same page about what you’d like to do and how, you can enjoy this experience together.

1. Talk with your partner

Anal sex shouldn’t be a surprise request mid-tryst, and no “Oops! It slipped!” excuses here — that’d be a major violation of trust and consent. If you’re interested in trying anal sex, have a conversation with your partner. Just out with it one day, and let them know you’re curious.

If the feeling is mutual, adventure awaits. If one of you decides anal sex just isn’t your thing, that’s OK. There are lots of options for spicing things up in the bedroom without adding anal sex.

2. Consider an enema

Worried that doing the dirty will, ahem, be dirty? It’s possible. If you want things squeaky clean down there, you can use an enema to clean the lower half of your rectum after a bowel movement, but it’s not necessary. You can find these products at most drug stores and pharmacies.

3. Cut your nails

Reduce your risk of cutting or scratching your partner by trimming your nails. Long nails might tear the thin, delicate tissue of the anus, which could lead to bleeding. It also increases the risk of spreading bacteria that could cause infections. Be sure to wash your hands well and scrub under your nails after anal sex, too, especially before inserting them into the vagina or mouth.

4. Wear a condom or dental dam

People who have anal sex have a higher risk of sharing STIs, but using a condom or dental dam reduces that risk. If you want to move from the anus to the vagina, be sure to use a new condom. If you’re not using a condom, wash the penis — or a toy if you’re using that — well before inserting it into the vagina.

5. Get in position

Many people find lying on their stomach with their partner behind them works well for anal sex. Missionary can work, too, as long as you adjust the point of entry. Doggy style is also an easy position. The receptive partner can slowly back up onto the insertive partner to control depth and pace.

6. Lube is a must

For comfort, you’ll need to provide your own lubricant — and plenty of it. Look for a water-based option, as it won’t break down the condom you’re wearing. Keep a wash cloth or baby wipes handy to clean up from excess lube.

7. Go slow and check in with your partner during

Don’t jump into anal sex cold. Give yourself 10 to 15 minutes of foreplay to warm up. This helps you — and the anal sphincter — relax, which can make the experience more enjoyable.

Take things slowly, use plenty of lubrication, and stop if it becomes too painful. Don’t aim to have full penis penetration your first go-round. Try using a finger, and then upgrade to two or three fingers. A toy might be a good option, too, as you grow more comfortable with the sensation. After the first time or two, you and your partner will likely find that the pleasure trumps any initial discomforts.

8. Accept that there will likely be some poop involved

This is, quite simply, a reality of anal sex. Even if you do wash or use an enema beforehand. If the idea of poop getting on you makes you uncomfortable, anal sex may not be the right option for you.

9. Clean up afterward or before you do anything else

Although your anus and rectum are cleaner than you might think, microscopic fecal matter will always be present. You can reduce your risk for infection by changing condoms and washing well. You should never go from anus to vagina or mouth without cleaning up first.

Can anal sex lead to orgasm?

Anal sex can lead to orgasm, but that doesn’t have to be the intended outcome. Anal sex can just be a fun way to play.

For some people, the anus is an erogenous zone. So even just a little play can be a turn on. The anus is also full of sensitive nerve endings, so it’s very receptive to sexual stimulation. For the insertive partner, the tightness around the penis can be pleasing as well.

Anal sex also stimulates the prostate gland in men, which can enhance a man’s orgasm. For women, clitoral stimulation may be necessary during anal sex to reach climax, but not every woman will reach orgasm this way. Oral or vaginal sex may be necessary to reach climax.

The bottom line

If you and your partner have an established relationship where you feel comfortable talking about what turns you on, what you’re curious about trying, and how you feel during sex, anal sex is another fun way to explore your sexuality. Take the proper precautions to make anal sex safe and enjoyable, and it can be a great option.

If you try it and you don’t like it, no harm done. There are a myriad of other ways to have fun, enjoy one another, and experiment. Being open and honest with one another about the experience can help you grow and learn together.